Dependency of premature ventricular contractions on heart rate

Abstract Background Several types of antiarrhythmic drugs are known to induce QT prolongation and torsades de pointes. Case presentation An 84-year-old man was scheduled for open gastrectomy for residual cancer. He had been prescribed bepridil for atrial fibrillation that converted to sinus rhythm with prolonged QT interval in the operating room. After the surgery was initiated under general and epidural anesthesia, the patient’s heart rate decreased to 50/min and multifocal premature ventricular contractions appeared, followed by several episodes of torsades de pointes, each lasting for 5 to 15 s. Infusion of isoproterenol was started (0.01 μg/kg/min), and the heart rate was maintained at around 80/min. Premature ventricular contractions disappeared, and torsades de pointes did not recur during the surgery. The operation was completed uneventfully. The serum bepridil concentration was found to be extremely high postoperatively. Conclusions Bepridil-induced intraoperative episodes of torsades de pointes were successfully treated by increasing the heart rate with isoproterenol.

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Autonomic Dysfunction Predicts Early Cardiac Affection in Patients with Systemic Sclerosis

Clinical Medicine Insights Arthritis and Musculoskeletal Disorders ◽

10.4137/cmamd.s4940 ◽

2010 ◽

Vol 3 ◽

pp. CMAMD.S4940 ◽

Cited By ~ 11

Author(s):

Khaled M. Othman ◽

Naglaa Youssef Assaf ◽

Hanan Mohamed Farouk ◽

Iman M. Aly Hassan

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Systemic Sclerosis ◽

Cardiac Function ◽

Cardiac Involvement ◽

Holter Monitoring ◽

Significant Negative Correlation ◽

Skin Thickness ◽

Noninvasive Methods ◽

Premature Ventricular Contractions

Objective To detect the early preclinical alterations in cardiac autonomic control as well as altered cardiac function in systemic sclerosis (SSc) patients and their relevance to the clinical features of the disease using noninvasive methods. Methods 30 SSc patients and 15 healthy controls matched for age and sex underwent clinical examination, serological analysis, and echocardiographic assessment including Doppler flow imaging to evaluate cardiac function, and 24-hour Holter monitoring analyzed for arrhythmia and heart rate variability (HRV) in the time and frequency domains. Results The trans-mitral Doppler of early to atrial wave (E/A) ratio was reversed in five patients (16.6%) and the tricuspid E/A ratio was reversed in 10 patients (33.3%). Holter analysis for SSc patients revealed an increased prevalence of premature ventricular contractions (PVC) ≥ 10/h ( P = 0.02), supra-ventricular tachycardias (SVTs) ( P = 0.2), and total PVC count ( P = 0.0000). Highly significant ( P = 0.000) impairment in all HRV parameters was demonstrated in the SSc patients. Total skin thickness score (TSS), Raynaud's phenomenon and anti-scleroderma 70 (anti-SCL70) showed significant positive correlations with all arrhythmia parameters, while showing a significant negative correlation with the impaired ventricular diastolic function and various HRV parameters. No correlation was found between arrhythmia and HRV parameters and disease duration, disease type, or presence of anti-centromere antibodies. Conclusion Low heart rate variability, increased TSS and the presence of anti-SCL70 are correlated with preclinical cardiac involvement in SSc patients and may predict the likelihood of malignant arrhythmia and sudden cardiac death. Therefore, noninvasive HRV evaluation before clinical cardiac involvement in these patients might be beneficial when added to the clinical and laboratory assessments in detecting high-risk patients, and may allow for implementation of preventive measures and initiation of appropriate therapy early in the course of the disease.

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Microgravity decreases heart rate and arterial pressure in humans

Journal of Applied Physiology ◽

10.1152/jappl.1996.80.3.910 ◽

1996 ◽

Vol 80 (3) ◽

pp. 910-914 ◽

Cited By ~ 105

Author(s):

J. M. Fritsch-Yelle ◽

J. B. Charles ◽

M. M. Jones ◽

M. L. Wood

Keyword(s):

Heart Rate ◽

Arterial Pressure ◽

Cardiac Rhythm ◽

Orthostatic Intolerance ◽

Diastolic Pressure ◽

Systolic Pressure ◽

Microgravity Environment ◽

Systematic Evaluation ◽

Premature Ventricular Contractions ◽

Cardiovascular Variables

Spaceflight causes adaptive changes in cardiovascular physiology, such as postflight orthostatic intolerance, that can have deleterious effects on astronauts. In-flight cardiovascular data are difficult to obtain, and results have been inconsistent. To determine normative in-flight changes in Shuttle astronauts, we measured heart rate, arterial pressure, and cardiac rhythm disturbances for 24-h periods before, during, and after spaceflight on Shuttle astronauts performing their normal routines. We found that heart rate, diastolic pressure, variability of heart rate and diastolic pressure, and premature ventricular contractions all were significantly reduced in flight. Systolic pressure and premature atrial contractions also tended to be reduced in flight. These data constitute the first systematic evaluation of in-flight changes in basic cardiovascular variables in Shuttle astronauts and suggest that a microgravity environment itself does not present a chronic stress to the cardiovascular system.

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Ambulatory blood pressure results and heart rate variability in patients with premature ventricular contractions

Clinical and Experimental Hypertension ◽

10.1080/10641963.2017.1356846 ◽

2017 ◽

Vol 40 (3) ◽

pp. 251-256 ◽

Cited By ~ 3

Author(s):

Lutfu Askin ◽

Mustafa Cetin ◽

Serdar Turkmen

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Ambulatory Blood Pressure ◽

Premature Ventricular Contractions

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Pilot study of the relationship between heart rate and ectopy and unrestricted vs restricted visiting hours in the coronary care unit

American Journal of Critical Care ◽

10.4037/ajcc1993.2.2.134 ◽

1993 ◽

Vol 2 (2) ◽

pp. 134-136 ◽

Cited By ~ 20

Author(s):

DA Schulte ◽

LO Burrell ◽

SH Gueldner ◽

MH Bramlett ◽

B Fuszard ◽

...

Keyword(s):

Heart Rate ◽

Coronary Care Unit ◽

Premature Ventricular Contractions ◽

Unit Design ◽

Natural Support ◽

Group A ◽

Coronary Care ◽

Group B ◽

The Relationship ◽

Coronary Care Units

OBJECTIVE: To determine the relationship between cardiac performance (as measured by heart rate and ectopy) and unrestricted vs restricted visiting hours in the coronary care unit. DESIGN: Patients were from two coronary care units. Group A had unrestricted visiting hours, and group B had restricted visiting hours. Heart rate and ectopy were measured three times both in patients with unrestricted visiting hours and in those with restricted visiting hours: (1) before visitors arrived, (2) 5 minutes after visitors arrived and (3) 1 to 5 minutes after the visitors left. A total of 25 visits were analyzed. FINDINGS: There were no significant differences in rates of premature ventricular contractions and premature atrial contractions between the two groups. Patients with unrestricted visiting hours had a significantly lower heart rate after visits than patients with restricted visits. CONCLUSION: Consideration should be given to development of unrestricted visiting policies that promote the continuing presence and natural support of the family and significant others for patients in coronary care units.

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Management of adolescent anorexia with symptomatic bradycardia and frequent premature ventricular contractions: a case report

Journal of International Medical Research ◽

10.1177/03000605211050179 ◽

2021 ◽

Vol 49 (10) ◽

pp. 030006052110501

Author(s):

Fuxu Chen ◽

Chao Feng ◽

Jie Song ◽

Shudong Xia

Keyword(s):

Heart Rate ◽

Anorexia Nervosa ◽

Pacemaker Implantation ◽

Premature Ventricular Contractions ◽

Cardiac Intervention ◽

The Past ◽

Electrocardiographic Monitoring ◽

Symptomatic Bradycardia ◽

Mean Heart Rate

Syncope associated with bradycardia and ventricular arrhythmia is an indication of cardiac intervention. However, in adolescent patients with anorexia nervosa, the management of syncope and arrhythmia can be different. We present a case of a 17-year-old boy who was admitted to the hospital because of syncope during exercise. Electrocardiographic monitoring showed that his mean heart rate was 41 beats/minute, with many long pauses and frequent premature ventricular contractions. These results suggested that the syncope was probably caused by arrythmia. He had been on a diet and had lost 20 kg in the past 6 months, with a body mass index of only 15.3 kg/m2. He was diagnosed with anorexia nervosa. Pacemaker implantation or ablation was not performed. Refeeding therapy was performed with mirtazapine. A follow-up showed a stepwise increase in his heart rate and a stepwise decrease in premature ventricular contractions, with an increase in his body weight. The findings from this case show that vagal hyperactivity associated with anorexia nervosa might lead to multiple premature ventricular contractions and bradycardia.

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